Proposed macroscopic quality indicators of antimicrobial stewardship in primary care: An observational study - 06/02/25
, E. Pouly a, L. Malinowski c, X. Bertrand a, bHighlights |
• | Macroscopic quality indicators (MQIs) can be calculated from quantitative data without any diagnosis-specific information. |
• | MQIs are complementary to other indicators in the community. |
• | MQIs provide feedback to general practitioners for urinary tract infections and ears nose and throat infections. |
• | MQIs are useful even in locations with lower levels of antibiotic use. |
Abstract |
Objective |
The objective of this study was to evaluate the ability of two macroscopic quality indicators to guide antibiotic stewardship strategies.
Methods |
Setting: Bourgogne-Franche-Comté region (eight departments).
Antibiotic reimbursement data, expressed in defined daily doses, were used to calculate two macroscopic quality indicators from 2015 to 2020. Urinary tract infection indicator: (fosfomycin + nitrofurantoin + pivmecillinam) / (ciprofloxacin + ofloxacin + norfloxacin) calculated in women aged 15 to 64. Indicator for ear, nose, throat and respiratory tract infections: (amoxicillin/ (amoxicillin-clavulanate + oral 3GC) calculated in children under 15 years of age.
Results |
In 2020, global antibiotic consumption varied from 22.2 to 26.6 defined daily doses per 1000 inhabitants per day, depending on the department. The macroscopic quality indicators were lowest in the departments of Nièvre and Yonne. The scores for the urinary tract infection indicator were 0.55 and 0.74, respectively, while those for the ear, nose and throat and respiratory tract infection indicators were 1.85 and 2.12, respectively. Both scores continuously increased in all departments of the region during the survey, except in 2020 for the urinary tract infection indicator, due to a nitrofurantoin shortage.
Conclusion |
Even in departments with low antibiotic consumption, our macroscopic quality indicators help to identify antibiotic stewardship targets for the most common community-based infections,. They are easy to calculate from quantitative data without requiring any information on diagnosis. Complementarily to other indicators, they provide messages specifically addressed to general practitioners regarding population, molecules and diagnostic elements.
Le texte complet de cet article est disponible en PDF.Keywords : Antibiotic stewardship, Ears nose throat infection, Macroscopic quality indicator, Urinary tract infection
Plan
Vol 55 - N° 1
Article 105013- février 2025 Retour au numéro
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